tbuckley/cabot-search huggingface dataset:
Systolic Hypertension in the Elderly
Authors: Suman Vardan
Journal: JAMA (1983)

Twenty-three patients older than 50 years, with systolic hypertension, underwent hemodynamic study. Cardiac output and stroke volume varied widely, with several high values. An elevated systemic vascular resistance, when considered as a function of the cardiac output, was the most prevalent hemodynamic abnormality. After administration of hydrochlorothiazide, 50 mg/day, for one month in 20 patients, 18 had a significant fall in BP, systemic vascular resistance, and stroke volume. After one year of continuous therapy, the hemodynamics, studied in 14 patients, did not change further. There were no clinical difficulties with carbohydrate intolerance, azotemia, hyperuricemia, or hyopkalemia. No patient had symptoms of orthostatic hypotension or cardiac arrhythmias. Thus, thiazide therapy effectively and safely lowers the BP in most patients with systolic hypertension by reducing systemic vascular resistance. (<i>JAMA</i>1983;250:2807-2813)
AIDS and Suicide
Authors: Richard M. Glass
Journal: JAMA (1988)

The acquired immunodeficiency syndrome (AIDS) epidemic has clearly involved the extremes of human emotions—for both its victims and the general public struggling to come to terms with it. The acquired immunodeficiency syndrome has fostered panic, hatred, and hopelessness, as well as instances of love and compassion in the face of fear and dread. Visual images of these emotional extremes have varied from the distorted faces of parents with ill-informed rage and fear about the presence of a child who is seropositive for human immunodeficiency virus (HIV) antibodies in their children's school to the Pope embracing a child with AIDS on his recent tour of the United States. Although any serious illness can involve strong feelings, the intensity of emotional responses to AIDS may be at least partially due to its linkage of two of life's most powerful experiences—sex and death. See also p 1333. In this issue of THE JOURNAL,
Effect of Captopril on Progression to Clinical Proteinuria in Patients With Insulin-Dependent Diabetes Mellitus and Microalbuminuria
Authors: Giancarlo Viberti
Journal: JAMA (1994)

<h3>Objectives.</h3> —To study the effect of angiotensin converting enzyme inhibition on the rate of progression to clinical proteinuria and the rate of change of albumin excretion rates in patients with insulin-dependent diabetes mellitus and persistent microalbuminuria. <h3>Design and Setting.</h3> —Randomized, double-blind, placebo-controlled clinical trial of 2 years' duration at 12 hospital-based diabetes centers. <h3>Patients.</h3> —Ninety-two patients with insulin-dependent diabetes mellitus and persistent microalbuminuria but no hypertension. <h3>Intervention.</h3> —The patients were randomly allocated in blocks of two to receive either captopril, 50 mg, or placebo twice per day. <h3>Measurements.</h3> —Albumin excretion rate, blood pressure, glycosylated hemoglobin level, and fructosamine level every 3 months; urinary urea nitrogen excretion every 6 months; and glomerular filtration rate every 12 months. <h3>Results.</h3> —Twelve patients receiving placebo and four receiving captopril progressed to clinical proteinuria, defined as an albumin excretion rate persistently greater than 200 μg/min and at least a 30% increase from baseline (<i>P</i>=.05). The probability of progression to clinical proteinuria was significantly reduced by captopril therapy (<i>P</i>=.03 by log-rank test). Albumin excretion rate rose from a geometric mean (95% confidence interval) of 52 (39 to 68) to 76 (47 to 122) μg/min in the placebo group but fell from 52 (41 to 65) to 41 (28 to 60) μg/min in the captopril group, a significant difference (<i>P</i>&lt;.01). Mean blood pressure was similar at baseline in the two groups and remained unchanged in the placebo group but fell significantly, by 3 to 7 mm Hg, in the captopril group. Glycosylated hemoglobin levels and glomerular filtration rate remained stable in the two groups. <h3>Conclusions.</h3> —Captopril therapy significantly impeded progression to clinical proteinuria and prevented the increase in albumin excretion rate in nonhypertensive patients with insulin-dependent diabetes mellitus and persistent microalbuminuria. (<i>JAMA</i>. 1994;271:275-279)
TREATMENT OF OSTEOPOROSIS
Authors: Karen M. Prestwood, M.D, Carol C. Pilbeam, M.D, Lawrence G. Raisz, M.D
Journal: Annual Review of Medicine (1995)

▪ Abstract Osteoporosis is a common disorder affecting the health of many adults. Strategies for fracture prevention include optimization of peak bone mass and prevention of bone loss at menopause and with aging. Genetic, nutritional, and life-style factors influence peak bone mass and may be used to focus preventive efforts. Once peak bone mass is reached, increased bone resorption may be the major pathogenetic factor. Calcium plus vitamin D, estrogen replacement therapy, calcitonin, and etidronate are agents currently available for treatment of osteoporosis; they act by inhibiting bone resorption. The failure of bone formation to keep pace with bone resorption also contributes to bone loss. Fluoride and intermittent parathyroid hormone therapy increase bone formation; however, more data are needed to determine efficacy. Insulin-like growth factors, transforming growth factor-β (TGF-β), and bone morphogenetic proteins may stimulate bone formation, but they have not yet been tested clinically. New approaches to treatment of osteoporosis will emerge as our understanding of the pathogenesis increases.
Studies in Myasthenia Gravis
Authors: Paul A. Kirschner
Journal: JAMA (1969)

Twenty-one patients with myasthenia gravis have undergone transcervical total thymectomy since November 1967. This procedure is based upon embryologic and anatomic considerations complemented by familiarity with mediastinoscopy. Advantages are the brief, bland, postoperative course and simplified management of myasthenia by avoiding a large, painful, chest-splinting sternotomy incision. Contraindications include large, inaccessible thymomas and low-lying preexisting tracheostomy. At the end of one year, three patients had borderline remission, six showed improvement and three showed no change. Eight patients were operated on too recently to evaluate. There was one postoperative death. Transcervical total thymectomy is now our surgical procedure of choice in myasthenia gravis.
Circumcision in the United States
Authors: Edward O. Laumann
Journal: JAMA (1997)

<h3>Objective.</h3> —To assess the prevalence of circumcision across various social groups and examine the health and sexual outcomes of circumcision. <h3>Design.</h3> —An analysis of data from the National Health and Social Life Survey. <h3>Participants.</h3> —A national probability sample of 1410 American men aged 18 to 59 years at the time of the survey. In addition, an oversample of black and Hispanic minority groups is included in comparative analyses. <h3>Main Outcome Measures.</h3> —The contraction of sexually transmitted diseases, the experience of sexual dysfunction, and experience with a series of sexual practices. <h3>Results.</h3> —We find no significant differences between circumcised and uncircumcised men in their likelihood of contracting sexually transmitted diseases. However, uncircumcised men appear slightly more likely to experience sexual dysfunctions, especially later in life. Finally, we find that circumcised men engage in a more elaborated set of sexual practices. This pattern differs across ethnic groups, suggesting the influence of social factors. <h3>Conclusions.</h3> —The National Health and Social Life Survey evidence indicates a slight benefit of circumcision but a negligible association with most outcomes. These findings inform existing debates on the utility of circumcision. The considerable impact of circumcision status on sexual practice represents a new finding that should further enrich such discussion. Our results support the view that physicians and parents be informed of the potential benefits and risks before circumcising newborns.
Tricyclic Antidepressant Overdose
Authors: John T. Biggs
Journal: JAMA (1977)

Forty consecutively hospitalized patients who had overdosed primarily with a tricyclic antidepressant (TCA) were observed until discharge. The severity of the overdose was documented by serial measurements of plasma TCA levels. Nineteen of the patients became comatose, 16 required supportive respiration, and 2 died. Individual symptoms in the 13 patients having plasma TCA levels greater than 1,000 ng/ml are shown. Plasma TCA measurements more reliably define patients who are at risk for major medical complications following overdose than does the amount of drug ingested by history. In the absence of plasma measurements, a QRS duration of 100 msec or more on a routine ECG within the first 24 hours defined all patients with major TCA overdoses. (<i>JAMA</i>238:135-138, 1977)
Medical Uses of the Wood's Lamp
Authors: Richard M. Caplan
Journal: JAMA (1967)

A Wood's lamp is a source of ultraviolet radiation of wavelengths centered around 3,650 Angstrom units, and ranging from approximately 3,200 A to 4,000 A. It thus excludes most of the burning and tanning rays shorter than 3,200 A and the visible light rays longer than 4,000 A. This portion of the electromagnetic spectrum is also called long-wave ultraviolet, near ultraviolet, or blacklight. For many years it has been known that near ultraviolet will excite fluorescence of a great many substances, a fact much exploited in advertising, industry, and general scientific investigations. Physicians and medical investigators have also used this type of energy to help understand some of the biologic processes that concern them. Such uses are the subject of this paper. Although one may employ complicated and powerful equipment plus precise and expensive filters to obtain greater precision of wavelength and higher energy levels, most Wood's lamps fortunately are
Diagnosis With Wood's Light
Authors: Kenneth M. Halprin
Journal: JAMA (1967)

In this article I shall discuss the usefulness of the long-wavelength ultraviolet light emitted by the Wood's light in the diagnosis of several forms of porphyria. The porphyrias are a group of disorders due to abnormalities in the production of the protoporphyrin part of the heme molecule ( heme = protoporphyrin + iron). In all forms of the disease, excessive amounts of one or more of the various precursors of protoporphyrin or of protoporphyrin itself are produced. In acute intermittent porphyria, which is characterized by neurological complaints, the earliest precursors ( δ-aminolevulinic acid and porphobilinogen) are excreted in the urine. These compounds have not yet become porphyrins and do not fluoresce. The patients are not sensitive to sunlight. All other forms of porphyria are characterized by sun sensitivity and the presence of porphyrin compounds in serum and tissues in elevated amounts. Porphyrins absorb long-wavelength ultraviolet light (4,000 Angstrom) and emit light of a longer
The Use of β-Blockers After Myocardial Infarction
Authors: Zoltan G. Turi
Journal: JAMA (1983)

DESPITE a decreasing incidence of coronary artery disease, myocardial infarction remains the leading cause of death in the industrialized nations of the world, with more than a half million deaths yearly in the United States alone. While much of the mortality occurs within the first few hours after infarction, there is also a very high death rate during the following six months (Fig 1). Mortality among infarct victims who survive the first week is still in the range of 15% in the first year (depending on the presence of various risk factors, this may range from 2% to upward of 50%) and may be 3% to 4% per year thereafter. The concept of prevention of reinfarction and death after myocardial infarction, ie, secondary prevention, has been actively investigated for the past two decades. Until quite recently, however, almost all efforts at demonstrating secondary prevention had failed. Thus, studies of antiplatelet
ACE Gene Polymorphism in COPD
Authors: Harry R. Gosker, Herman-Jan Pennings, Annemie M. W. J. Schols
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Despite the growing field of interest in the role of pulmonary oxidative stress in chronic obstructive pulmonary disease (COPD), barely any data are available with respect to antioxidant capacity in the peripheral musculature of these patients.The main objective of this study was to assess in detail the antioxidant status in skeletal muscle of patients with COPD.Biopsies from the vastus lateralis of 21 patients with COPD and 12 healthy age-matched controls were analysed.Total antioxidant capacity, vitamin E, glutathione, and uric acid levels were determined and the enzyme activities of superoxide dismutase, glutathione reductase, glutathione peroxidase, and glutathione-S-transferase were measured.Malondialdehyde was measured as an index of lipid peroxidation.The total antioxidant capacity and the uric acid levels were markedly higher in COPD patients than in healthy controls (25%, P ¼ 0:006 and 24%, P ¼ 0:029; respectively).Glutathione-Stransferase activity was also increased (35%; P ¼ 0:044) in patients compared to healthy subjects.Vitamin E level was lower in patients than in controls (Po0.05).The malondialdehyde level was not different between the two groups.It can be concluded that the muscle total antioxidant capacity is increased in patients with COPD.Together with the reduced vitamin E levels, the increased glutathione-Stransferase activity and normal levels of lipid peroxidation products, these findings suggest that the antioxidant system may be exposed to and subsequently triggered by elevated levels of reactive oxygen species.
Stat Bite: Worldwide Breast Cancer Mortality, 1986-1988
Authors: B. Merz
Journal: JNCI Journal of the National Cancer Institute (1992)

Stat Bite: Worldwide Breast Cancer Mortality, 1986–1988 Get access Beverly Merz Beverly Merz Merz is a Chicago-based freelance writer Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 84, Issue 11, 3 June 1992, Pages 833–834, https://doi.org/10.1093/jnci/84.11.833 Published: 03 June 1992
Variation in Journal Peer Review Systems
Authors: Lowell L. Hargens
Journal: JAMA (1990)

To investigate disciplinary differences in how scientific journals evaluate submissions, I collected data from the<i>Astrophysical Journal, Physiological Zoology</i>, and the<i>American Sociological Review</i>. Referees' evaluations of submissions to these journals differed strikingly: nearly half of the referee reports for<i>American Sociological Review</i>recommended outright rejection, while the corresponding proportions for the other two journals were about one fourth and one tenth. Final dispositions show even greater variation, with<i>Astrophysical Journal</i>accepting 91% of submissions,<i>Physiological Zoology 59%, and American Sociological Review</i>13%. The journals also differed substantially in the average number of revisions of eventually accepted papers and the average time lags between submission and final editorial decisions. Such differences conform to claims that disciplinary differences in consensus on research priorities and procedures contribute to variation in typical journal peer review systems. Review systems, in turn, influence authors' experiences in the peer review process. (<i>JAMA</i>. 1990;263:1348-1352)
Effect of Mandatory Radiology Consultation on Inpatient Imaging Use
Authors: Robert L. Bree
Journal: JAMA (1996)

<h3>Objective.</h3> —To determine if a mandatory radiology consultation service can decrease radiology resource use on inpatient internal medicine services. <h3>Design and Setting.</h3> —Randomized controlled trial on 4 internal medicine services at a university hospital. <h3>Patients and Other Participants.</h3> —Six radiologists performed the intervention on 2 internal medicine services over a 12-month period. A total of 1022 patients were admitted to the 2 intervention services and 1178 patients were admitted to the 2 control services. Each was staffed by an attending internist and 3 house officers. <h3>Intervention.</h3> —Each radiology examination required approval by the attending radiologist before it was performed. <h3>Main Outcome Measure.</h3> —Relative resource costs (relative value units [RVUs]), number of examinations per patient, proportion of patients with 1 or more tests, and mean length of stay (LOS). <h3>Results.</h3> —Mean RVUs for the intervention group were 356.1, and for the control group, 336.0 (<i>P</i>=.5). Mean examinations per patient for both groups was 4.4. Mean LOS for the intervention group was 6.0 days, and for the control group, 6.1 days (<i>P</i>=.8). <h3>Conclusions.</h3> —An inpatient radiology consultation service, with a goal to reduce resource use, did not achieve its goal. A more appropriate use of time and expense for radiology utilization management may be in the outpatient setting.
Injectable Fluid Silicone Therapy
Authors: Richard Ellenbogen
Journal: JAMA (1975)

Four patients who had received silicone injections had the following complications: migration, hepatic disease manifested as granulomatous hepatitis (previously undescribed, to our knowledge), hypopigmentation, and death. Silicone should now be considered as a possible cause of hepatic granulomas in an appropriate host. (<i>JAMA</i>234:308-309, 1975)
Postoperative Adjuvant Chemotherapy With Fluorouracil, Doxorubicin, Cyclophosphamide, and BCG Vaccine
Authors: Aman U. Buzdar
Journal: JAMA (1979)

Two hundred twenty-two patients with stage II or III breast cancer following regional therapy were treated with a combination of fluorouracil, doxorubicin hydrochloride (Adriamycin), cyclophosphamide, and BCG vaccine. At 54 months of study (median follow-up, 30 months), the estimated proportions remaining disease-free two and three years after surgery were 83% and 78%, respectively, in the chemotherapy group and 64% and 55%, respectively, in 151 historical control patients. Estimated two- and three-year survival rates were 93% and 89%, respectively, in the chemotherapy group and 84% and 58%, respectively, in the control patients. Congestive heart failure has developed in three patients, possibly related to the use of doxorubicin. Adjuvant chemotherapy with these drugs was effective in prolonging the disease-free interval and survival of patients irrespective of menopausal status, degree of nodal involvement, or stage of the disease. (<i>JAMA</i>242:1509-1513, 1979)
Is it all right for women to drink small amounts of alcohol in pregnancy? Yes
Authors: Pat O'Brien
Journal: BMJ (2007)

The National Institute for Health and Clinical Excellence draft guidance on drinking during pregnancy has added to confusion about safety. <b>Pat O9Brien</b> believes that telling women to abstain is overly paternalistic on current evidence, but <b>Vivienne Nathanson</b> and <b>colleagues</b> argue that this is the safest message
Colchicine in Acute Gout
Authors: W. Neal Roberts
Journal: JAMA (1987)

Colchicine is an effective and relatively specific treatment for acute gout and has a long, venerable history. Serious toxic reactions to colchicine could be prevented if guidelines for its use were followed strictly, but because of its relatively infrequent use and conflicting recommendations, considerable toxic effects might occur and still be undetected by passive surveillance. A review of a teaching hospital's four years' experience showed two deaths (2% incidence) due to inappropriate use. Colchicine has the smallest benefit-to-toxicity ratio of drugs that are effective for acute gout. This article gives specific recommendations for the use of colchicine in different clinical settings. (<i>JAMA</i>1987;257:1920-1922)
Severe Necrotizing Soft-Tissue Infections
Authors: E. Patchen Dellinger
Journal: JAMA (1981)

The spectrum of severe soft-tissue surgical infections extends from synergistic necrotizing soft-tissue infections to histotoxic clostridial infections. These syndromes may demonstrate dramatic destruction of underlying tissue far out of proportion to the external evidence for infection, although a marked systemic response is common. The differential diagnosis hinges on the clinical presentation, the Gram's stain, and operative inspection. More important than the precise label placed on a given case is the early recognition of the urgent surgical nature of the infection. Signs indicating a rapidly spreading soft-tissue infection mandate fluid resuscitation, broad-spectrum antibiotics, and early operative exploration with aggressive debridement. These are highly lethal infections in which timely recognition and effective managment may be lifesaving. (<i>JAMA</i>1981;246:1717-1721)
Smoking research of the 1950s could be celebrated in UK and US stamps
Authors: J. H Lutschg
Journal: BMJ (2000)

Smoking research of the 1950s could be celebrated in UK and US stampsEditor-Tobacco Control reproduced anti-tobacco postage stamps on the covers of its first six issues. [1]2][3][4] By 1992, 43 countries had issued anti-tobacco stamps, 1 and Poland issued an antismoking postcard as far back as 1971.Sixty five countries have now issued anti-tobacco stamps or other postal items.Two of the recent issues are from Libya in 1995 and Romania in 1999 (figures).By contrast, 125 countries have
New Approaches to the Control of Infections Caused by Antibiotic-Resistant Bacteria
Authors: Ian Chopra
Journal: JAMA (1996)

<h3>The Emergence of Antibiotic-Resistant Bacteria and Its Consequences</h3> One of the most remarkable accomplishments of this century has been the successful development of antibiotics for the chemotherapy of bacterial infections.<sup>1</sup>These agents have produced impressive reductions in the morbidity and mortality imposed by microbial pathogens. Unfortunately, the increasing widespread emergence of acquired resistance to antibiotics over the last 40 years now constitutes a serious threat to global public health<sup>1-3</sup>and is a growing problem in both hospital-acquired (nosocomial) and community-acquired infections. The antibiotic resistance problem is exacerbated by the genetic exchange of resistance determinants among bacteria.<sup>1-3</sup>In addition, demographic factors, such as population growth and urbanization, generate conditions that may facilitate the transmission of infections. New opportunities for interspecies traffic of new pathogens to human beings may occur as a consequence of human colonization in previously undisturbed rural ecosystems and accompanying perturbation in host-pathogen ecology.<sup>4</sup>Bacterial
"Blister Cells"
Authors: Gungor Karayalcin
Journal: JAMA (1972)

Peripheral blood smears of two pregnant women with sickle cell disease who had clinical evidence of pulmonary embolism revealed significant numbers of erythrocytes having the appearance of "blister cells." These cells resemble a round or conical basket with a handle, giving the appearance of a cell with a large vacuole at one pole but with intact cell membrane. One patient had homozygous hemoglobin SS disease and died three days after hospitalization. The second patient had hemoglobin SC disease and recovered. A normal infant was born to this patient ten weeks later. "Blister cells" were not observed in 15 patients (one pregnant) with hemoglobin SS disease, and four patients (one pregnant) with hemoglobin SC disease without pulmonary infarction.